Form NHTSA Form 1335 NHTSA Form 1335 Buzz Driving Screener

Focus Group Studies Under Generic Clearance - Recruitment Screener

OMB Control No: 2127-0682

Expiration Date 04/30/2018

Recruitment Screener

Focus Groups to Develop Impaired Driving Prevention Public Service Advertising Campaign

Generic Clearance OMB Control No: 2127-0682: Focus Groups for Traffic and Motor Vehicle Safety Programs and Activities

NOTE TO RECRUITER: Ask to speak to any male age 21 to 34 (note: age range and gender is critical). If none available, terminate. (T) indicates terminate instruction.

IF A CHILD ANSWERS THE PHONE: May I speak with a parent or adult who lives in the household?

Hello, this is __________________, from (NAME OF FOCUS GROUP COMPANY), calling on behalf of the U.S. Department of Transportation. We are conducting a study of American’s opinions about a highway traffic safety issue. I would like to ask you a few questions to determine if you are eligible. (INTERVIEWER NOTE: If necessary, read):

This collection of information is VOLUNTARY and will be used for formative purposes only so that we may develop communications programs designed to reduce the number of traffic-related injuries and deaths. Public reporting burden is estimated to average 10 minutes, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. We will not collect any personal information that would allow anyone to identify you. Please note that a federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB control number. The OMB generic control number for this collection is 2127-0682.

I would like to ask you a few questions to determine if you are eligible for the study.

Could we begin now?

( ) Yes

( T ) No

IF NO, TERMINATE OR SCHEDULE CALLBACK

1. RECORD SEX:

( T ) FEMALE

( ) MALE

ASK TO SPEAK WITH MALE IN HH.

2. Into which of the following ranges does your age fall? (READ)

( T ) Under 21

( ) 21 - 27

( ) 28 - 34

( T ) 35-44

( T ) Above 45

RECRUIT A MIX OF AGES 21-27 & 28-34.

3. Have you participated in a focus group discussion or one-on-one research interview in the past 6 months, either in your home/office or at another location?

( ) Yes SKIP TO Q3b

( ) No SKIP TO Q3c

3b. What was the topic of that discussion or interview? _________________________________

TERMINATE IF TOPIC WAS RELATED TO ALCOHOLIC BEVERAGES OR DRINKING.

3c. Where do you work? _____________________________Record answer

3d. What industry is that? ____________________________ Record answer

Do not read list below… check answer against list and terminate accordingly.

Terminate if “yes” to any)

( T ) Marketing, advertising, public relations or marketing research

( T ) News media, including newspaper, television, radio or publishing

( T ) Alcohol, beer, wine and spirits

( T ) Law enforcement

( T ) Legal

( T ) Local, state or federal government

RECRUIT MIX OF WHITE AND BLUE COLLAR OCCUPATIONS ACROSS GROUPS.

4. How often do you drive to places in a vehicle (car, truck, motorcycle etc.?)_ (READ LIST)

( ) All the time

( ) Once in a while

( T ) Rarely

5. Which of the following statements describes your driving habits in a typical week? (READ LIST)

( ) I drive mostly on weekdays, like when I commute to/from work or school.

( ) I spend the most time behind the wheel on weekends (Friday- Sunday).

( ) I drive most days of the week.

( T ) I drive very little. My vehicle spends more time in its parking spot than on the road

( T ) Refused

RECRUIT A MIX

6. What social activities have you done with friends, work colleagues, or a significant other in the past three weeks? (DO NOT READ LIST)

( ) Dining out with friends

( ) Going to the movies

( ) Going to a friend’s house

( ) Attending concerts or theater productions

( ) Attending house parties

( ) Going out for drinks after work

( ) Entertaining friends in my home

( ) Going to bars, sports bars or taverns

( ) Going to beer or wine tasting events

( ) Going to nightclubs or lounges

( ) Going bowling

( ) Playing pool or billiards

( ) Attending professional sporting events

( ) Going to casinos or other gaming establishments

( ) Other _____________________________

RECRUIT A MIX. MUST CHECK 3 OR MORE RESPONSES IN Q6 TO CONTINUE. OTHERWISE TERMINATE.

7. Which of the following best describes your drinking habits when it comes to alcoholic beverages? (READ LIST)

( T ) I never drink

( T ) I rarely drink except for on an occasional holiday or special occasion ( ) I drink in social situations 1- 2 times per month

( ) I drink in social situations 1- 2 times per week

( ) I drink in social situations 3 or more times in a week

7a) When you’re out how many drinks do you typically have? (DO NOT READ LIST)

( T ) I may have one drink but that’s it.

( ) I generally drink 1 to 2 drinks each time

( ) I generally drink 3 or more drinks each time

8. What is your current employment status? (READ LIST)

( ) Employed full time

( ) Employed part time

( T ) Retired

( ) Full-time student

( ) Stay-at-home parent

( ) Temporarily unemployed

MAX ONE FULL-TIME STUDENT PER GROUP. MAX ONE UNEMPLOYED PER MARKET.

9. Which of the following best describes your level of formal education? (READ)

( T ) Less than high school

( ) Graduated from high school

( ) Received GED

( ) Attended college, but have not graduated

( ) Completed a vocational school program

( ) Graduated from a two-year college

( ) Graduated from a four-year college or university

( ) Attended or completed graduate school

( ) Currently attending college or vocational school

RECRUIT A MIX

10. Are you of Hispanic or Latino descent?

( ) Yes

( ) No

10a. Select one or more of the following that best describes your race:

(ACCEPT MULTIPLE RESPONSES)

( ) American Indian or Alaska Native

( ) Asian

( ) Black or African American

( ) Native Hawaiian or Other Pacific Islander

( ) White

RECRUIT A MIX OF RACE/ETHNCITY

11. Which of the following ranges includes your annual household income? (READ LIST)

( T ) Under $20,000

( ) $20,000 - $29,999

( ) $30,000 - 49,999

( ) $50,000 – 79,999

( ) $80,000 - 99,999

( ) $100,000 and over

12. Which of the following best describes your current relationship status?

( ) Married or in a relationship

( ) Single

( ) Prefer not to state

ANY SELECTION QUALIFIES FOR PEER GROUPS.

13. I’d like to finish by asking you a question that is a complete departure from the type of questions I’ve been asking you to this point. There are no right or wrong answers and it’s an opportunity to use your imagination:

If you had the opportunity to spend one hour with a famous person – either from the past or present – who would that person be?

Why did you pick this person? Please be as specific as possible.

( ) Articulate and creative.

( T ) Not articulate or creative

INVITATION TO RECRUIT INDIVIDUAL RESPONDENTS

Thank you for helping with this survey. I would like to invite you to a research discussion. We are interested in holding a discussion to speak with you

The discussion would be held on MM/DD/YY at XX:XX, and the session will last approximately 90 minutes. You will receive $75 cash incentive for your participation. Your participation is strictly voluntary. Would you be interested in joining us?

INVITATION TO RECRUIT PEERS (FOR INITIAL RESPONDENT IN EACH GROUP)

Thank you for helping with this survey. I would like to invite you to a research discussion. We are interested in holding a discussion to speak with you and a friend or work colleague who you have socialized with/had drinks with regularly in the past few months. If you agree to participate, we would like you to give us the name and contact details of a friend who we will call and ask to attend. We ask that those friends also fall in the [21-34] year old age range. The discussion would be held on MM/DD/YY at XX:XX, and the session will last approximately 90 minutes. You and you friend will each receive $75 cash incentive for your participation. Your participation is strictly voluntary. Would you be interested in joining us?

INVITATION FOR PEERS RECOMMENDED BY INITIAL RESPONDENT

Before we proceed, can you tell us your age?

( T ) Under 21

( ) 21 -34

( T ) Over 34

Thank you for helping us with this survey. We have one quick question for you. When was the last time you socialized with [friend who recommended you] while having drinks? (Interviewer Note: Look for an answer in the past 4 weeks.) We would like to invite you to a research discussion to be held on MM/DD/YY at XX:XX. The session will last approximately 90 minutes. We understand the demand on your schedule; therefore, you will receive $75 cash incentive for your participation. Your participation is strictly voluntary.

Would you be interested in joining us?

( ) Yes

( T ) No

ADVISE INVITEES THAT IF THEY REQUIRE EYEGLASSES TO BE

SURE TO BRING THEM TO THE INTERVIEW

END OF SCREENER GUIDE

NHTSA Form 1335 Page 10